The Responsible Resident
The Responsible Resident Podcast is a short-form educational series designed for medical students, residents, and fellows who want clarity around financial decisions during training, without pressure, sales, or noise.
Hosted by Amber Stitt, co-owner of MD Disability Quotes and a 15-year specialist in physician income protection, this podcast focuses on what truly matters during medical training: timing, underwriting, and protecting future earning power.
Most residents believe financial decisions can simply be handled later. What this series explains, calmly and clearly, is that some decisions are influenced by health history and timing. Flexibility exists during training, but it does not last forever.
You don’t need to take action immediately. The goal is competence first, so when decisions matter, you’re prepared.
If you’re in training and want to understand your options before they narrow, this podcast is for you.
The Responsible Resident
How To Pick the Best Disability Insurance Purchase Option - RR Ep 8
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What are Future Purchase Options (FPO), Future Increase Options (FIO), and Benefit Increase Riders (BIR) in disability insurance, and how do physicians use them to grow coverage over time?
Disability insurance for physicians, income protection, and future increase riders explained clearly.
In this episode of The Responsible Resident, Amber Stitt breaks down how physicians can increase disability insurance coverage as income grows, without going through medical underwriting again.
Learn the difference between the Future Increase Option (FIO) rider and the Benefit Increase Rider (BIR), how each works, and when each may be appropriate based on career stage, income trajectory, and employer disability coverage.
This episode covers key disability insurance concepts, including:
- How future purchase options protect insurability
- Annual vs periodic increase opportunities
- Financial underwriting vs medical underwriting
- How employer group disability insurance impacts private coverage
- Why residents, fellows, and early attendings often rely on built-in increase features
Understanding how disability insurance riders work allows physicians to design income protection strategies that evolve with their careers while maintaining flexibility and control.
Subscribe for more physician-focused education on disability insurance and financial planning.
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To Download the FREE Medical Professionals Blueprint:
If you would like a free quote, please contact us at:
mddisabilityquotes.com/responsible-resident
Amber Stitt is a disability insurance specialist with over 15 years of experience helping physicians protect their income and make informed financial decisions.
As the host of The Responsible Resident, she brings a structured, education-first approach to topics like disability insurance, underwriting, and income protection, areas often overlooked during medical training.
🔗 Connect with host, Amber Stitt, on Social Media:
📲 Be sure to visit the Stitt Strategies website:
🎬 And remember, let's take action today!!!
Welcome to The Responsible Resident. I'm Amber Stitt. This podcast takes a common sense approach to financial decisions for physicians, breaking down complex topics into something clear, practical, and usable. Because you shouldn't have to have a finance degree to build financial freedom. Today's topic is an important one for residents, fellows, and early attendings reviewing disability insurance policies. Future purchase options. FPOs are another way to refer to these. This is the parent name of this type of feature. Specifically, we're going to break down the difference between two features physicians often see in disability insurance contracts. The future increase option, often called an FIO writer, and the benefit increase writer, sometimes called a BIR. Both features allow physicians to increase their coverage later without going through medical underwriting again. But they work differently, and understanding those differences can help you design a policy that grows with your career. Why future increase options exist was highlighted via the story in episode three about our surgeon client named Claire. Since physicians often purchase their first disability insurance policy during residency or early in their career, income may still be relatively modest compared to what it will be later. But over time, physician income tends to grow as you complete training, transition into attending roles, build production or partnership income, or grow your practice. Future purchase features exist so physicians can increase disability coverage as income grows without needing to re-qualify medically. That means if your health changes later in your career, you can still increase your coverage. What is a future increase option? FIO A Future Increase Option Rider allows a physician to purchase additional disability insurance in the future with financial documentation only. These options to increase are available one time a year around the policy anniversary. If there is a gap in coverage, you can prove the income change and then fill that gap. That means no new medical exam, no new labs, and no medical underwriting review. So if income has increased enough to justify more coverage, you may be able to increase the monthly benefit. How the FIO writer works. The future increase option typically allows physicians to increase their coverage over time, up to a predetermined maximum allowed by income rules. Some common characteristics include the ability to purchase up to several multiples of the original base benefit over time. Requests are typically made on policy anniversary dates. Increases are usually limited to one request per year, but there are some exceptions. Financial documentation is required to confirm the increased income. Certain career events may also trigger opportunities to increase coverage earlier, such as a substantial increase in income, graduating from residency or fellowship, or losing employer group disability coverage. The key benefit of the FIO writer is protecting your future insurability, meaning your health does not need to be reevaluated when increasing coverage later. I'd like to take a second to tell you about a free medical professionals blueprint that I created with you in mind. At some point in your career, you realize it's not just about making more money, it's about making decisions that actually support your life. That's exactly why I created the Pathways Perspective for Physicians. It's a simple, non-technical framework to help you think through your career, your money, your risk, and how everything connects as your life evolves. You shouldn't have to have a finance degree to build financial freedom. You don't need to have everything figured out. You just need a place to start. You can download the free Medical Professionals Blueprint at stitstrategies.com forward slash blueprint. What is a benefit increase writer? The benefit increase writer works toward the same goal, increasing coverage as income grows, but it is structured a bit differently. This rider allows physicians to increase coverage every three years, depending on the structure of the contract. There are also similar exceptions to the three-year rule, like with the FIO discussed earlier. How does the benefit increase rider work? The benefit increase rider typically includes features such as increasing benefits without medical underwriting, requiring financial documentation depending on the amount of increase requested, and allowing increases up to current issue and participation limits with a specific minimum and maximum allowed. To keep the rider active, physicians typically need to check in during the anniversary window by submitting documentation. Another important feature is that this rider is commonly included at no additional cost on many policies issued to physicians early in their careers. The trade-off here is that you have to submit documentation during your policy anniversary, or this free feature can be forfeited. Your advisor should be helping you with this into the future. They are compensated to help you with reminders and submitting paperwork when the time is right. What is most common now, present day? Today, many physicians, particularly residents, fellows, and early attendings, often choose the benefit increase rider rather than purchasing the future increase option rider. One reason is that the benefit increase rider is frequently included automatically on policies at no additional cost. Another factor relates to employer disability insurance. As we discussed in earlier episodes, many physicians working for hospitals or health systems receive disability insurance through their employer. That employer coverage can sometimes limit how much private disability insurance you are allowed to purchase, especially early in your career. Because of these participation limits, many physicians may not yet qualify for large increases in private coverage. For that reason, the free increase features built into many policies are often sufficient during the early years of practice. How do you decide between the FIO or the BIR for yourself personally? Both the future increase option and the benefit increase writer exist to solve the same problem. Your income will likely grow throughout your career. These riders allow your disability insurance coverage to grow with it, while protecting your ability to increase benefits without medical underwriting. The right structure often depends on factors such as career stage, current income, employer disability coverage, and long-term financial planning strategy. If you do not foresee income changing that rapidly as an attending, and if you are not production-based, the benefit increase writer could be a great fit for you. High production specialties and those that are in private practice settings may consider an FIO instead. Our team is always happy to help review which is the best for you. To wrap up this episode, future purchase options are one of the most important planning tools in disability insurance for physicians. Because your career and income are likely to change significantly over time, building flexibility into your coverage early can help protect your financial future. Understanding how these riders work allows physicians to design coverage that can evolve as their careers develop. In the next episode of The Responsible Resident, we'll cover another decision physicians often face when purchasing disability insurance. Should you buy a fixed premium or a graded premium? We'll break down how each pricing structure works and how physicians think about these options early in their careers. Stay tuned for more information-packed episodes to help you make the right decisions for your life and your financial future. If this episode helped you think a little more clearly about your next step, that's the goal. You don't need to have everything figured out, but you do need to take ownership and take a meaningful step forward today. Thanks for listening to The Responsible Resident Evil. It is not legal, tax, or individualized financial advice, and coverage options will vary based on your personal situation.